Predisposing factors for excessive loss of weight in exclusively breastfed term and late preterm neonates - a case control study.

Exclusively breastfed healthy neonates can lose weight excessively due to poor milk production, inadequate enteral intake or due to poor milk transfer. The studies assessing risk factors for infants to lose weight excessively are diverse and results are highly varied. We aimed to determine the risk factors for weight loss of over 10% in term and late preterm newborns who were exclusively breastfed. This was a case-control study which was conducted in a tertiary care hospital. Exclusively breastfed neonates of ≥34 weeks having weight loss of >10% in the first 14 days of life comprised the study group with gestational age and weight-matched neonates without significant weight loss forming the control group. Demographic details, LATCH score, maternal EPDS (Edinburg postpartum depression score) and neonatal morbidities were assessed. Of the 53 mother-infant dyad in each group, baseline characteristics were similar. Gestational Diabetes Mellitus (GDM), Lower segment Caesarean section (LSCS) delivery, higher EPDS score, low LATCH score, absence of immediate skin to skin contact were associated with excessive weight loss and was found to be significant statistically. Babies in the study group had higher incidence of jaundice and hypernatremia and had longer duration of stay in hospital. Lack of early skin to skin contact, higher EPDS scores and lower LATCH scores are predisposing factors for exclusively breastfed infants to lose weight excessively.